Head and Neck Complications of Bone Marrow Transplantation

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In the late 1950s, the technique of human marrow transplantation was first applied, and these initial attempts were viewed with enthusiasm as a means to treat blood dyscrasias or marrow failure. However, these early attempts often met with failure; in a study of 203 of the early marrow grafts, only 22 (11%) were unequivocally successful allogeneic transplants [1]. The problems preventing success included graft failure, graft-versus-host disease (GVHD), bleeding and infectious complications resulting from marrow and immunologic ablation, and recurrence of disease [2]. During the 1960s, advances in histocompatability typing, pretransplant conditioning, immunosuppressive therapy, and improved supportive care and infection control laid the groundwork for a resurgence of human marrow grafting. Today, marrow transplantation is considered an effective treatment for severe aplastic anemia, acute leukemias, and immunodeficiency disorders [3–5] (see chapter 8).